Postsecondary institutions in Canada pride themselves on being able to offer advanced courses and information to the public. Presumably, this material is more sophisticated than that taught in grade school. And it is assumed that the information offered has a bearing on reality and is supported by the best evidence available. We do not, for example, expect to enroll in a college math course and be taught that a triangle has four sides, nor would we anticipate that a college biology course would tell students that the human heart has three chambers.
Such an assumption of quality assurance seemed justified for most of the last century. But postsecondary institutions have other concerns as well. Many wish to appear relevant to the surrounding communities. Others may be mindful of a need to increase revenue—possibly by offering courses that may be outside normal standards of academic rigor. The wish to answer a perceived public desire also plays a role.
A few years ago members of our committee visited a college in the Lower Mainland to discuss the merits of their plan to offer a degree program in a field lacking scientific justification. When one member suggested that the physicists at that institution might object if astrology courses were offered, a senior administrator interjected, “Excuse me, but if we became aware that there was an interest in that topic, we would seriously consider offering courses in it.”
Whether in response to current fads, the need for more tuition funds, or some other motivation, many institutions entrusted with adult learning seem to be offering an increasing number of health courses that fly in the face of well-established knowledge.
At another BC college students can earn credit for a course in Therapeutic Touch (TT). The calendar explains that this is “a gentle holistic practice that balances energy fields around the body to facilitate the healing process.” In another course, students are taught that people with ADHD—particularly children—can be helped with homeopathy, which will address their “disruptions in life-force energy.” Other programs claim to advance the understanding of human health through the use of flower remedies, reflexology, and the healing power of crystal bowls.
This is not a trend isolated to Vancouver or to British Columbia. There is a concern continent-wide that health education, particularly outside university settings, is becoming increasingly divorced from scientific knowledge. One of the key features of the Flexner Report of 1910 was the recommendation that medical education be tied to institutions engaged in basic science research so that new discoveries could be translated into better health care. This message—responsible for much of what we now take for granted in our health care—seems to be disappearing from the calendars of many adult learning and postsecondary institutions.
While such a process may generate revenue or appear to be responsive to the community, it may be a Faustian bargain in that the long-term consequences of mis-educating the public about human health will almost certainly make it more difficult for people to make rational health decisions when they’re needed, let alone communicate with their physicians.
Parents would be upset if their children were being misinformed in school, and the same standard should apply to schools that teach adults.
—Lloyd Oppel, MD
Chair, Allied Health and Alternative Therapies Committee
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
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